The Orgy Room at the Adonis Club

We each deal with death in a different way. As nurses we are expected to remain strong, rarely discussing how we are affected emotionally by our jobs.

I opened my email a few weeks ago and outwardly cringed. Yet another requirement to be fulfilled in the next 3 weeks for our accreditation, eight hours of clinical to be shoehorned into an already insane schedule. Opening day of trauma season had come and gone, so the slow winter shifts were officially over.

Cardiology has always been a weakness. I used to look at Chris (fellow student and partner in crime) during my grad school days and laugh as he made a box with his hands over his heart saying, “this is all I care about Emily, you can have the rest.” His great interest was cardiology, I would passionately express my distaste for it.

Fast forward to a conversation with Ben, who works in a cardiothoracic ICU. He too loves everything about cardiology, has an amazing passion for it as a matter of fact. So as the stars aligned, I received permission to spend a shift with him.

As I have no credentials at his institution, I was looking forward to 12 hours of being the ‘newbie.’ You remember those days. No license to do anything other than follow an experienced nurse around with awe in your eyes. Strange to be back in that mind set knowing what I now know.

Late in the day, we recovered a double by-pass patient, but this post isn’t about Swan-Ganz catheters, cardiac parameters, or vasoactive drips. This post is about another patient. One who gave much more to me than me to him, as only our patients can do.

His spinal surgery went well. Although his extensive cardiac history made it risky, the surgeon deemed him well enough for the OR. His young chronological age, I’m sure, being part of the decision process. His physiological age seemed much greater. HIV had done a number on him, as had his multiple previous myocardial infarct ions.

Just prior to discharge, he suffered ‘the big one.’ A heart attack that landed him in the CT-ICU, assigned to Ben, and by default, me. His DNR/DNI (do not resuscitate/do not intubate order) was a source of early discussion.

David became an exercise in clinical medicine versus patient care.

I have known Ben for quite some time in an Army capacity, and as a friend. Caring for this patient with him, opened my eyes to a side of him that could have taken years for me to see otherwise.

The intern shed her lab coat and took an inordinate amount of time to gather her supplies. Somehow they convinced David to have an arterial line inserted. To Ben and I it was obvious that this was something he didn’t want. He knew his days were numbered and was at peace with it. They explained in depth how the muscle of his heart was not going to continue working well. At best he would have debilitating CHF (congestive heart failure) for the remainder of his life and they needed the a-line to get an accurate measure of his blood pressure; and therefore be able to treat him.

His partner of 28 years was at his side doting on him. They discussed what he should do and David reluctantly agreed. He knew that it was a temporary measure only to help with temporary treatment. While the obviously nervous resident went about setting up her sterile field, Ben and I intermittently spent time at his bedside with wet cloths for his forehead and conversation to distract him from the looming procedure. Ben’s easy way, quick smile and confidence permeated the room, putting David at ease.

Earlier that day, Ben turned the corner with a grin from ear to ear. “Emily, you know how long David and his partner have been together?”

I shook my head trying not to smile at the almost mischievous grin plastered on his face.

“29 years!”

As we were all packed in David’s room, it was inevitable that Ben ask where David met his partner.

David’s mother had warned us earlier about the extent of David’s wicked sense of humor. We were given brief peeks at it when he mustered enough energy for a zinger, cracking us up throughout the day.

After Ben’s inquiry, David did not hesitate. “I met him in the orgy room of the Adonis Club. He was the only one I ever had breakfast with.” His grin at the memory and joy at the expected reaction we gave him was something I will never forget. David lived life his own way and it showed even when lying sick in an ICU bed.

As the resident proceeded to attempt small talk, thinking it was hiding her nervousness at the procedure, Ben and I exchanged looks over the bed. This was going to be ugly. Although we kept an eye on the monitor, watching his low pressure measured by the BP cuff, we instead focused on his pale face, on his forehead beading with sweat. Ben brought more wet cloths, I held David’s hand.

Through my training, I have done those difficult procedures, been nervous as I felt all eyes on me. I also knew when to quit. I knew when to actually look at my patient, give them permission to say no. The inside of my cheek and lip were almost bloody as I kept biting them, keeping me from saying something which was not my place to say. I could see it in Ben’s eyes as well. We exchanged a glance and I quietly walked out, Ben slid up to David, and took my place.

There was an order to make David NPO (nothing by mouth) and neither the intern, the resident nor the chief resident knew why. “Guess it was just in case cardiology wanted to do a procedure.” They didn’t even question it, but instead just wrote it. There was no way on earth a cardiologist was going to touch David. Where was the critical thinking that would do what was right for David?

At some point I re-entered the room after giving Ben an exasperated look when no one could see me but him.

The resident decided he was going to take over stabbing David’s radial artery. After tucking his tie into his dress shirt he put on sterile gloves which were way too large.

On his way to the clean utility room he stated, “Well, guess I am a 7.5 not an 8!”

Before any of us could blink David piped up, “Well, I wouldn’t go around bragging about that!”

Ben and I almost lost it we were laughing so hard.

After coming back to laughter directed at him, and going through another 3 catheters unsuccessfully, the resident stopped to discuss what to do next with the chief resident who at some point appeared in the room. As the residents were discussing the difficultly of getting the catheter placed, Ben and I quietly told David it was okay to take a break and by giving him that permission, enabled David to put an end to the madness.

After clarifying the NPO orders and cleaning up the mess the residents left, we spent the remainder of our time with David making him as comfortable as possible. I stood to the side as David’s mother and sisters thanked Ben for everything he had done, his mother close to tears. She recently lost not only her husband, but her brother and now was on the verge of losing her son. Without stopping to think Ben reflexively stepped forward and pulled this small woman into a protective, caring embrace which she un-hesitantly, and gratefully, accepted.

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Ben sent me a text message today. David, who has not been far from our minds, died last weekend.

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May I find the courage to face death as he did, with a wicked sense of humor, surrounded by those who love me, all the while knowing that I lived life on my own terms.

nicely told. I LOVE hearing stories like these, and I’m also so happy to tell them. The last procedure done on my dad was a swan ( I think), and I can remember him intubated/sedated grimacing and turning his head to the side, (I saw this as him cursing, like they were hurting him) I knew his brain function was still there. Your stories make me proud to be a nurse! I’m taking that dang test again…………. swear i’ll pass this time……….ahhhhhhhhhhhhhhhhhhh